Improving standards of oral hygiene in intensive care

Excerpt

Sir: Although the survey of oral care in European intensive care units undertaken by Rello et al. [1] was not demographically representative of those individuals participating at the European Society of Intensive Care Medicine Congress, it nevertheless reinforces the findings of previous studies. Despite data demonstrating that colonisation of the oropharynx with potentially pathogenic bacteria precedes the development of ventilator-associated pneumonia (VAP) [2], and that the latter can be reduced by oral decontamination [3], the oral cavity remains an area neglected by critical care practitioners. Too often resources are placed in elaborate approaches of reducing VAP such as subglottic aspiration ports, antimicrobial coated endotracheal tubes or automatic adjustment of endotracheal cuff pressures, instead of the simple measure of cleaning the oral cavity which may prove equally or possibly more effective. …